Tuesday, 19 February 2013

What will the closure of the Independent Living Fund mean for disabled people with high support needs?

Last year, I wrote about the history of the Independent Living Fund and why we need to defend it.  At that point, the Fund was closed to new applicants and in July last year the government consulted on closing it entirely and transferring the over 19,000 current ILF grant holders to local authority funding.

In response to that consultation, the Minister for Disabled People announced that “In April 2015 the ILF will close and from that point local authorities in England, in line with their statutory responsibilities, will have sole responsibility for meeting the eligible care and support needs of current ILF users.”

A Judicial Review has been granted of the government’s consultation process and is due to be heard on March 13th.  Disabled People Against the Cuts are organising a vigil outside the court in London. 

Since it was set up in 1988, the ILF has enabled people with the highest levels of support needs to live in their own homes and to have choice and control over the support they need to go about their daily lives. Some people who receive ILF grants talk about what a difference it makes to their lives here

The ILF is something of an anomaly in that it is a national system of allocating resources, whereas most other support to disabled people is delivered via local authorities, and this is a reason given by the government for abolishing the Fund.  Nonetheless, since 1993 ILF users have had to qualify for a certain amount of support from their local authority before they can access an ILF grant so a more accurate representation is of the ILF as a way of providing a ‘top up’ to local authority resources so that those with the highest support needs can have access to opportunities for an ordinary life.

The overwhelming response to the consultation from disabled people currently receiving ILF funding was summed up by the government: “ILF users tended to believe that local authority assessments of care needs were excessively budget driven and the ILF applied a more needs based approach. Users said they feared that the local authority may reduce the care package they currently receive or would not fund the type of activities that the ILF does.”

In response, the government stated that “All disabled people, including those transferring from the ILF, will continue to be protected by a local authority safety net that guarantees disabled people get the support they need.” 

The nightmare facing many people who are currently supported to live in their own homes is that they will, at best, be left with just ‘life and limb’ support (the ‘safety net’ that the government refers to) or, at worst, be forced into residential care.  That this is a realistic fear is evident from the local authority responses to the consultation.

The Association of Directors of Adult Social Services and the Local Government Association were in no doubt that most people would receive less support than they currently get: “As ILF recipientstransfer into the LA system in 2015, and are subsequently reviewed against the FACS criteria, the value of the personal budget calculated through the Resource Allocation System (RAS) will generally be at a lower level than the initial  ILF/LA budget

The government’s own Impact Assessment acknowledged that “some users may not receive the same level of support or be able to use their funding in the same way as they currently do”, while the National Association of Financial Assessment Officers (the people who carry out the means-test to determine whether disabled and older people should be charged for their care) told the government “some councils may determine that residential care would be a less expensive option than a high cost homecare package. “

There is a long history of local authorities operating informal ‘caps’ (linked to the cost of residential care) on how much they will pay to support someone living in their own home.  This has primarily affected older people and there are fears that – with ever-tightening budgets – such a practice will also now increasingly be applied to people under the age of 65.  Local authorities are always very careful in the language they use to describe such policies as they would be acting unlawfully if they ‘fettered their discretion’ by applying a blanket limit on the amount of money to be spent on supporting people to live in their own home.  Thus we see the example of Worcestershire County Council consulting on a ‘Maximum Expenditure Policy’   while insisting that this does not mean they will impose a ‘cap’ on expenditure.  George Orwell would have loved such an example of ‘doublethink’ (i.e. simultaneously accepting two mutually contradictory beliefs as correct).

The majority of people who receive funding from both the ILF and their local authority receive support costed at over £500 per week.   These are people with the highest levels of support needs who, in previous generations, would have been consigned to institutions.  The ILF has been particularly effective at enabling people with ‘complex needs’ (a combination of physical and learning disabilities) to live in the community, supported by their families.

Much of recent public debate about social care has been focused on older people but disabled people of working age in fact account for an increasing proportion of the total expenditure on social care.  Although they account for only a third of total service users, “there is evidence that there is a growing number of LAs where .....expenditure for people aged under 65 is approaching the levels of expenditurefor people aged over 65”.

Currently, social care for disabled people of working age is under-funded and many people do not have their basic needs met. Local authorities will experience a 28% cut in their overall budgets by 2015.  Are we now going to see a reversal of the trend – experienced over the last 50 years – of a move away from institutional care for people with the most significant impairments?

If local authorities cannot envisage being able to continue funding the levels of support needed by current recipients of ILF grants, what chance is there for people with high support needs in the future to receive help to enable them to live ‘ordinary’ lives in their communities? 

(1) Blackmore, T. 2013. Local Authority Social Care Expenditure: A discussion paper, Disability Cornwall and Isles of Scilly. 

Friday, 1 February 2013

PIP - Foolishness personified

My last blogpost argued that neither the Conservative government which introduced Disability Living Allowance in 1992, nor the current Conservative-led Coalition government, which is replacing it with Personal Independent Payment, paid much attention to evidence when developing these policies.

On the other hand, in the 1970s the initial versions of these ‘extra costs’ benefits were informed and motivated by research evidence.  As Tania Burchardt says, “The development of extra costs benefits appears to be one of the relatively few areas where social research has had a direct impact on policy”

Two areas of social research prompted the introduction of Attendance Allowance by the Conservative government in 1971 and Mobility Allowance by the Labour government in 1975.  Surveys by the Office for Population Censuses and Surveys identified larger numbers of disabled people than had previously been thought, and the significant costs faced by disabled people (1). There was also increasing evidence about the negative impact of means-testing benefits - the low take-up, the high costs of administration and the ‘poverty trap’ created for low income households (2). This helped to persuade the 1970-74 Conservative government and the 1974-79 Labour government that the new Attendance and Mobility Allowances should not be means-tested.

It is interesting that both Attendance Allowance and Mobility Allowance were introduced during times of worsening economic conditions.  In particular, it is perhaps surprising that during an economic crisis which resulted in significant public expenditure cuts in return for an IMF loan in 1976, the Labour government brought in a new extra costs disability benefit which it estimated would significantly increase the numbers eligible for help with mobility.  Less than 50,000 people qualified for the three forms of help which were replaced by Mobility Allowance – the three-wheeler ‘trike', the small cars, and the Personal Car Allowance.  In contrast, the government estimated that 150,000 people would qualify for the new Mobility Allowance (3).

When Mobility Allowance was first introduced in 1975, it was paid at £4 per month but over the next three years it increased to £10.  This was partly to enable the payments to be enough for the new car leasing scheme, Motability, launched in 1978.  While this was set up with finance from the main banks, working with the car industry, the organisation also received government grants towards the cost of administration and to subsidise expensive adaptations.

So, at a time of significant economic crisis and large reductions in public expenditure, there was all-party support for, not only increasing the amount spent on disability benefits but also for introducing a scheme which resulted in many thousands of disabled people having access to a car.

In retrospect, we can see what a wise decision this was. Because not only did this benefit disabled people but it also benefited the wider economy.

By 2009, Motability was estimated to support 21,080 jobs; contribute £2 bn to the UK’s GDP; and £468m in tax receipts every year. It accounts for 10% of new cars and 2.5% of used cars sold every year.
In the current economic difficulties, however, the government is taking a very different approach – one which, far from generating demand in the economy and protecting the living standards of disabled people, is reducing the numbers who are helped with additional costs and in particular who can have access to a car.

The DWP estimates that 420,000 fewer people will be awarded the enhanced rate of the mobility component of the new Personal Independent Payment than were eligible for the equivalent rate of Disability Living Allowance.
In a Briefing to the All Party Parliamentary Disability Group on January16th, Motability stated “We recognise that a significant number of our current customers will lose their eligibility to use the Scheme as a result of their PIP reassessments”. 

Motability's website makes clear that “If you are an existing DLA recipient who has not received the Enhanced Rate of the Mobility Component of PIP, you will not be eligible to use the Motability Scheme” and “The leasing agreement will end” and “Motability will arrange with you for the vehicle to be returned”.  
Not only will this have a devastating effect on individuals and their families, but it will have a significant detrimental effect on the economy.  Using analysis from 2009, Jane Young has estimated that there will be losses of:
  • 5,692 jobs (from 21,080 jobs to 15,388 jobs in Motability-related industries)
  • £544 million contribution to GDP (from around £2 billion to £1.45 billion)
  • £126 million in tax receipts.
Can anyone doubt that the introduction of Personal Independence Payment – which is entirely fueled by a desire to reduce the money spent on supporting disabled people’s additional costs – is one of the most foolish policies ever pursued by a government?

(1)  Harris, A. 1971. Handicapped and Impaired in Great Britain, Office for Population Censuses and Surveys.
(2) e.g. Lister, R. 1974. Take up of Means-Tested Benefits, Child Poverty Action Group.
(3) Beard, A. 1998. Motability: The Road to Freedom, The Book Guild.